How to GRADE the evidence: Inconsistency

GRADE approach to evaluating the quality of evidence: a pathway


This lesson is the fourth in the series of online learning materials designed to help guideline developers and authors of systematic reviews learn how to use the GRADE approach to grade the evidence in systematic reviews, to create Summary of Findings Tables and GRADE Evidence Profiles, and move from evidence to making recommendations.

This lesson introduces inconsistency as a criterion for assessing the quality of a body of evidence. It explains how to detect heterogeneity or inconsistency in results and describes the reasons to downgrade for inconsistency. Examples are provided as an exercise in applying the criterion of inconsistency to grading the quality of evidence.

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After using this resource, you should be able to...
  • recognize and explain inconsistency in a body of evidence
  • decide whether or not to downgrade the quality of evidence based on inconsistency

How to GRADE the evidence: Inconsistency

Author information: 
Sch√ľnemann, Holger; Santesso, Nancy

Prepared by Holger Sch√ľnemann and Nancy Santesso from the Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada. Funding for the development of this lesson was provided by the Cochrane Collaboration through the grant 'Training and Capacity Building for Summary of Findings Tables' and the World Health Organization.